ABSTRACT
Obejective: To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root. Methods: Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted in situ without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation. Results: All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed. Conclusion: The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity.
ABSTRACT
BACKGROUND: Glomus tumor is a small encapsulated tumor that is derived from the subcutaneous glomus body. Treatment of subungual glomus tumor is the complete removal of the tumor. However, the surgical method is not familiar to us. OBJECTIVE: The aim of this study is to introduce surgical treatment results of subungual glumus tumor in dermatologic surgery clinic of Seoul National University Hospital and Seoul City Boramae Hospital from 1995 to 2002. METHOD: We reviewed the medical records and checked clinical aspects, surgical methods and results. RESULTS: All patients, 10, were female. Pain was elicited by contact in 80% and occurred spontaneously in 60%. Temperature hypersensitivity occurred in 50%. 90% of tumors were located in fingers. 70% of tumors revealed just blue or erythermatous discoloration of nail plate. Nail deformity was found in 30%. Post-operative mild distal nail splitting had developed in 2 cases. In 8 cases nails showed normal growth. Nobody complained of a recurrence of pain. CONCLUSION: Careful dissection and complete removal of the tumor almost offered permanent relief and it is thought that appropriate education of surgical skills should be needed and offered.